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Bone marrow T-cell subsets in patients with monoclonal gammopathies: correlation with clinical stage and disease
A Corso1, G Castelli, G Pagnucco
1Institute of Hematology, University of Pavia, Italy.
Background And Objective:
The existence of an imbalance in T-cell subpopulations in patients (pts) affected by monoclonal gammopathies (MG) has been well established. This imbalance might be correlated with different control of plasma cell growth and, particularly in MM, with the severity of the disease. The aim of this study was to verify whether the alteration of the T lymphocyte subsets in bone marrow correlates with the diagnosis, clinical status and disease phase in patients with monoclonal gammopathies.
Methods:
We performed a study on bone marrow (BM) T-cell subsets in 49 multiple myelomas (MM) and in 17 monoclonal gammopathies of uncertain significance (MGUS), using as controls 20 BM aspirates from normal subjects.
Results:
The percentages of BM CD4 cells in MM pts at onset were slightly lower than in controls and in MGUS pts, who showed normal percentages of CD4. The percentages of CD8 cells were lower than in controls in both MM and MGUS (p = 0.02 and p = 0.007, respectively), and consequently the CD4/CD8 ratios were significantly higher than in normal subjects (p = 0.01 and 0.008, respectively). Analysis of BM T-cell subpopulations in MM pts showed a progressive decrease in the percentage of CD4 cells from stage I to stage III (I vs III p = 0.008) and an increase in CD8 cells, although not statistically significant. The same trend was observed when the different phases of MM (onset, plateau, progression) were analyzed: a lower percentage of CD4 cells and an increase of CD8 cells characterized the advanced phases. Treatment did not seem to alter significantly the distribution of T-cell subsets in MM patients.
Interpretation And Conclusions:
The imbalance in T-cell involving the bone marrow lymphocytic populations that exist in MG is somewhat different in MGUS and MM. In MM patients this disturbance is related to the disease stages and phases, reflecting an important role for T-cell subsets in tumor cell control.
Insights
T-cell imbalances in bone marrow are present in monoclonal gammopathies (MG). In multiple myeloma (MM), these T-cell subset alterations correlate with disease severity and stages, suggesting a role in tumor control.
Area of Science:
- Immunology
- Hematology
- Oncology
Background:
- T-cell subpopulation imbalances are established in monoclonal gammopathies (MG).
- These imbalances may influence plasma cell growth and disease severity, especially in multiple myeloma (MM).
Purpose of the Study:
- To investigate correlations between bone marrow T-lymphocyte subset alterations and the diagnosis, clinical status, and disease phase in MG patients.
Main Methods:
- Analyzed bone marrow T-cell subsets in 49 multiple myeloma (MM) patients, 17 monoclonal gammopathies of uncertain significance (MGUS) patients, and 20 normal controls.
Main Results:
- Multiple myeloma (MM) patients showed lower CD4+ T-cells and higher CD4/CD8 ratios compared to controls and MGUS patients.
- T-cell alterations, including decreased CD4+ cells and increased CD8+ cells, worsened with advancing MM stages and phases.
- Treatment did not significantly impact T-cell subset distribution in MM patients.
Conclusions:
- Bone marrow T-cell imbalances differ between MGUS and MM.
- In MM, T-cell subset disturbances are linked to disease stage and phase, indicating a role in tumor cell regulation.